Should Amoxicillin Be Taken With Food?

The pharmacist answers our latest question regarding whether or not amoxicillin needs to be taken with food.

Question

My child was prescribed amoxicillin for a ear infection. Should I be giving that with food or does it not matter?

Asked by Kara On Dec 25, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Dec 25, 2018
Pouring Amoxicillin In Spoon

Answer

Immediate release amoxicillin products (e.g. capsules, suspension) can safely be taken with or without food. There are no interactions known that could potentially decrease effectiveness.

Per the prescribing information for amoxicillin capsules:

"Capsules, chewable tablets, and oral suspensions of AMOXIL may be given without regard to meals. The 400-mg suspension, 400-mg chewable tablet, and the 875-mg tablet have been studied only when administered at the start of a light meal. However, food effect studies have not been performed with the 200-mg and 500-mg formulations."

However, the extended release amoxicillin product, Moxatag, does have a specific recommendation when it comes to food. It is recommended to take either with food or within one hour of eating food:

"Patients should be informed that the recommended dose of MOXATAG is 775 mg once daily taken with food for 10 days. MOXATAG should be taken within 1 hour of finishing a meal and at approximately the same time every day."

It is true that certain antibiotics have significant interactions with food. One example is with tetracycline antibiotics. If taken with food high in calcium or magnesium, the total absorption of these antibiotics can be significantly decreased, which may alter effectiveness.

The prescribing information for doxycycline states:

"All patients taking doxycycline should be advised: that the absorption of tetracyclines is reduced when taken with foods, especially those that contain calcium. However, the absorption of doxycycline is not markedly influenced by simultaneous ingestion of food or milk."

So, overall:

  • Immediate release amoxicillin tablets, capsules and liquids can be taken with or without food.
  • Moxatag (amoxicillin extended release) should be taken with food or within one hour of food.

It is important to note that the most prevalent side effects of amoxicillin are nausea and general gastrointestinal discomfort.

Even though immediate release amoxicillin products don't have to be taken with food, doing so can help to reduce nausea and make them better tolerated. Several studies suggest giving it with food, especially in children and adolescents, to improve tolerability.


Answer Summary

Food does not alter the effectiveness of immediate release amoxicillin products. However, Moxatag (extended release amoxicillin) is recommended to be given with food or within one hour of finishing a meal.

About Amoxicillin

Amoxicillin is an "aminopenicillin" similar to ampicillin and penicillin. It is better absorbed than ampicillin, allowing for fewer daily doses and has a broader spectrum of activity compared to penicillin.

It is used to treat a variety of bacterial infections, including:

  • Ear infections
  • Sinus infections
  • Bronchitis
  • Cystitis

It is available in many different dosage forms, including capsules, tablets and liquid suspensions. The liquid suspensions are stable for 14 days at room or refrigeration, so refrigeration isn't required. Nevertheless, refrigeration is the recommended storage condition as it improves tolerability.


References
  1. Amoxil Prescribing Information. AccessFDA
  2. Moxatag Prescribing Information. AccessFDA
  3. Doxycycline Prescribing Information. AccessFDA

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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